In surgical practice, a genuine need often exists for a reliable, simple, and effective means for re-attaching tendons, ligaments, or other tissue which have become separated from the bone of a human or animal. Such separation may be due to injury, genetic defects, or may be the result of various surgical procedures.
It is preferable to re-attach such a tendon or ligament to the bone such that it may eventually heal and attach itself to the bone. In such a configuration, it may be understood that the attachment of the ligament or tendon to the bone must be sufficient to withstand loads seen during rehabilitation, which may include loads necessitated by physical therapy.
If the tendon or ligament cannot be attached to the bone such that grafting would occur, the attachment must be sufficient to withstand loads encountered not only during rehabilitation, but for the rest of the-patient's life.
It may be understood that particular needs are presented by such re-attachment requirements, such as a need to expediently perform the re-attachment procedure in order that the patient undergoes minimal trauma, as well as a need to provide a minimally-sized incision, in order to reduce the risk of infection and to minimize scarring.
A number of prior art methods and devices have been developed in order to address the above-discussed needs. However, the prior art known to the applicant does not adequately satisfy these needs.
It is known to utilize pliable sutures in order to attach tissue to bone, or tissue to tissue, by passing the suture through or around such elements, and subsequently hand tying the sutures in place. However, such methods are disadvantageous as it is difficult to determine the proper mount of tension to be applied to the sutures such that the sutures maintain adequate holding strength but do not break. Other disadvantages arise in that the space allowed to perform such tying techniques may be generally limited.
It is also generally known to staple ligaments or tendons to a bone, although such a method has significant drawbacks. If the staple is positioned too loosely, the ligament or tendon may become detached by slipping underneath the staple. If the staple is positioned too tightly on the bone, the ligament or tendon may be severed or "guillotined" by the staple, or disadvantageous tissue necrosis or death may occur.
U.S. Pat. No. 4,708,132 to Silvestrini, entitled "Fixation Device for a Ligament or Tendon Prosthesis", issued Nov. 24, 1987, discloses a device for affixing a pretensioned ligament or tendon prosthesis to a bone of a patient. It may be seen that a relatively complex anchor device is utilized, which requires the drilling of holes completely through various bones of the patient, necessarily requiring extensive surgical procedures.
U.S. Pat. No. 4,784,126 to Hourahane, entitled "Surgical Device", issued Nov. 15, 1988, discloses another method for surgery of which requires drilling of hole completely through a bone of a patient, such that on elongated clamp may be passed through the rear opening of the hole, in order to clasp a ligament and draw it through the front opening of the hole.
U.S. Pat. No. 5,482,451 to Moore, entitled "Glenohumeral Ligament Repair", issued Oct. 10, 1989, discloses a ligament repair kit and procedure for installing a. cannulated bone screw and ligament washer to retain a ligament on a bone. Further disclosed is a screw which is screwed to tighten a spiked ligament washer against the displaced ligaments to firmly hold them in place against the bone.
U.S. Pat. No. 4,889,110 to Galline et at., entitled "Attaching Device and Tools for Positioning Same, Especially for Attaching Trochanter Major to the Femur", issued Dec. 26, 1989, discloses an attaching device including an anchoring plate having four bores which receive two crimping tubes and two crimping rings for holding a multi-ply cable. The device is adapted to be used for attaching the trochanter major to the femur in the case of a trochanteric osteotomy.
Although at least some of the above patents do generally disclose attachment of a detached ligament to a bone, they include disadvantages in that they utilize complex attachment devices and procedures. Furthermore, the disclosed techniques require in some cases severe surgical incisions in order to access patient bone areas for drilling, which may disadvantageously cause patient trauma, unacceptable scarring, or infection.
Therefore, there is a need in the art to provide a reliable, simple, and effective means for re-attaching a tendon or ligament to a bone, in which minimal patient trauma is encountered, and minimum infection or scarring results.